Mental Paws

Feeling like I'm stuck in quicksand both mentally and physically has gotten old already, so I made an appointment with my primary care P.A., to discuss this downhill slide and how to turn it around. I needed to get labs done anyway since I haven't had my thyroid checked in a while. We did a CBC with diff, thyroid labs, and a vitamin D.

I am super deficient in vitamin D, which doesn't surprise me, so I will begin taking a supplement. That alone should help boost my mood and possibly make me less achy. Everything was fine with the thyroid, so it's not that. My CBC with diff was perfect. Not anemic, no blood issues whatsoever.

After we talked about all that's going on, we arrived at the same conclusion, that it's hormones and menopause and I'm right there in the thick of it, so this is how it's affecting me. I'm up 11 pounds, and I can't run right now because my back is still not quite right. I am able to walk and get on the bike though the motivation is the problem with the bike. My brain is out to a two margarita lunch, and I have no idea when it will be back.

I feel like I'm 90, but I'm about 7 weeks away from 51. It's nearly 70 degrees here today, and I can't even get out running to take advantage of it. I took Iris for a walk and she was dragging her butt. It hurts my butt and back with every step. Isabelle didn't even want to go. We're all feeling old today.

Speaking of old, there are lots of fossils and dinosaurs in the world, and they need to move on. We have a lot of them in our government, and in positions of power in our institutions such as health care. Even if they aren't old in years, sticking to the old way of doing things in a world that has changed, and fighting for dominance to continue the old ways, not only looks kind of silly but is unproductive and wasteful.

Spoiler alert: You'll be hearing more about Fighting Dinosaurs in the near future. When you see dinosaurs fighting each other and bashing each others' skulls in, you have to wonder why they are trying to hasten their mutual extinction, and killing everyone else off with their counterproductivity. I would have to describe the nursing profession as a bunch of dinosaurs. They are still trying to train people, in the 19th century image of Florence Nightingale, with a 20th century mindset, in the 21st century of the health care reform corporatocracy. To borrow a dinosaur term from last century, Stay tuned...

Happy Re-Birthday: A Year Out of the Dungeon

It's been one year since I left my corporate nursing job.

Just one year. Seems impossible that the time could go by so quickly, and so much could happen. But it seems like forever, really, like a distant nightmare. I was reading over some of what I wrote last year, and I am happy to say that I'm able to look at it without the emotion engulfing me. I've done a lot of healing in that time.

At first I missed the patients and some of my coworkers. But I've stayed in touch with the coworkers that mattered, and have more meaningful relationships with several. I've run into many of my former patients in town, and continue to work with a few of them, but in different ways now.

The work I do is so much more satisfying, I don't miss sticking needles in people or filling their veins with poison one bit. And I certainly don't miss punching a time clock so I could get a steady paycheck but feeling like I would have to sell my soul in order to keep getting one.

I have learned so much more since I left because I have more energy to read and research information on what's going on in cancer care far beyond the confines of a dingy little windowless cave subjected to the whims of toxic people who made decisions without considering the people they would affect most or asking for input from the nurses who worked with those people every day.

There are thousands upon thousands of nurses out there who have left what they felt were oppressive conditions in the workplace and moved on to something else. And I am just one.

Before I left corporate nursing I was surrounded by other nurses who were afraid. Some of them did not-so-nice things to each other, and to me. I no longer take it personally. Now my true colleagues are nurses who are not stuck in the system. They are not afraid. They have found a way out, and many of them have suffered great pain and loss to get to where they are now. Much worse than I did. They are a diverse group, some are employed in the profession, many are self-employed, many are out completely.

There is a common thread among most of these nurses, they love nursing and they would like the profession to change for the better, but there is a long climb ahead and it seems we lose ground on most days. Occasionally there is a bright moment, but then we fall back into the void. 

There is a definite hum that's picking up in intensity, the misplaced blame on nurses in the Ebola situation fueled it, but that's only a glimpse of the problems. Nurses have HAD IT.

I've been listening to and talking with a lot of nurses over the past year, all over the country, and in other countries too. I've been thinking about ways to fix things, ways to improve things, and most of the work I've done has focused on individual people, which is good on my own, but always knowing that in the big picture of health care, most of the work nurses are doing in those workplaces is like building sandcastles at low tide.

And when the tide comes in, it's more of a rip current, a crashing of water with overwhelming force, an undercurrent that knocks you off your feet and threatens to drown your breath and silence your voice forever.

And the damage it does comes from all of the following forces and more...

1. A two-tiered system where managers, administrators and executives answer to money and quantitative data (numbers that are now called "metrics") that have everything to do with what they like to call "quality" but really mean more busywork for the people who are supposed to be doing patient care, but that data really translates to "reimbursement" aka money. Meanwhile the other tier, nurses, physicians and other health care staff, take seriously their professional oaths and training to not do harm, and the two tiers have little mutual understanding of each others' obligations to their own callings (money/boards/shareholders/stockholders vs. moral and ethical obligations to patients, oaths and licensure), each speaking it's own language not fully understood by or ever truly communicated with the other tier.

2. Lack of leadership in the highest ranks of nursing organizations, which consist of leaders from industry and higher education who protect their own turf which goes against the best interest of working nurses.

3. A great amount of fear among workers that has been exacerbated by the past three decades of eroding workplace protections, a mainstream media that fosters unrestrained hate and divisiveness and fosters paranoia and misinformation, ignoring facts in favor of hype. Attacks on free speech (in the craze over the second amendment, seems we've forgotten the first) and organized labor, and legislation that favors the big corporate money interests, giving them the rights of individuals.

4. A system on steroids that intensifies the poor people skills and lack of empathy held by a great number of those who advance to administrative positions and executive power, leaving the staff at the bedside populated by people who care about patients' best interests but without a voice or support to help them.

5.Lack of advocacy or assertiveness by nurses for their own interests in their workplaces in the face of strongarm tactics used to intimidate and dismiss their concerns.

6. Eroding job security as employers look to part-time hiring, reducing staff, decreasing benefits, and electronic spying on employees both in and out of the workplace.

7. Increasing burnout due to the task-oriented nature of nursing work and increased demands to do more with less staff, working equipment, support, training, at the same time being faced with expectations to increase the amount of documentation time and checklists, taking away clinical judgment opportunities and interpersonal connection in patient care duties.

8. A work culture that values "yes-men and women" more than clinical skill or attention to safety, that provides disincentives to speak, disagree, or otherwise question the status quo, motives, or actions of "leadership".

9. A capitalistic system run amok where the distribution of wealth becomes more skewed all the time with no brakes to stop it.

10. A legal system run amok with power that works in favor of the wealthy white collar criminals who can afford to buy their own teams of attorneys, and can buy lobbyists to buy politicians who will work even more in their favor, with no brakes to stop it.

11. A health care system that enriches the top-end insurance companies and pharmaceutical companies, but makes no investment in the base of the pyramid: health education in schools to teach children how to manage their health from an early age, universal basic health education for people at all stages of their lives with and without disease, teaching chronically OR terminally ill people about palliative care, the options not to treat some illnesses, death education so it is accepted as part of life and not so feared and avoided at all costs.

12. A public health system that has been underfunded to the point of endangering public health by promoting misinformation and being embarrassingly unprepared for a crisis.

13. A for-profit so-called health care system (even though some of it calls itself not-for-profit but it is still working for profit) that results in competition to a degree that hurts patients' best interests by withholding information about options and resources available to them outside of an organization's domain. Health care is not at all about health, and it is not about caring. It is about making money off of chronic illness, of various types and trajectories.

14. The collective personality-disordered nature of "leadership": with it's insecure, narcissistic, sociopathic bent that has no empathy for patients or their families true needs, or the needs of direct patient care workers. This distorted method of leadership pursues matters in the interest of building their egos, power, status, bonuses, perks, and the ultimate perk of all, the insurance policy of guaranteed future personal economic security via outrageous sums of money upon leaving an organization regardless of the reason.

There's a lot to say, and I'm not done saying it. Just getting warmed up.

I'm not dead yet, and I won't be done until I'm dead. I don't know how long I'll live, but if I died today, I'd be okay with it.

Because at least I will know I tried, I spoke from my heart, I called out what I saw, and I felt the passion and the horror, witnessed the suffering and the relief, and I know I lived true to myself and my own principles.

And unlike those narcissistic shadows holding nooses around the necks of hardworking direct patient care nurses, I didn't look the other way knowing what I was doing, despite what I claimed and hid behind, was really not about caring for people but instead lining my own pockets and enriching myself at the expense of other people's well-being.

There are at least three differences now.

One is that I can say these things calmly, without the raging anger that I felt a year ago.

Two, I am on the lookout for solutions, and I know I am not alone, as I felt a year ago.

Three, I am pursuing my passion, and I have no one holding me back, I have lost the shadow and the noose of a year ago. 

Every day I wish the same for my fellow nurses who are feeling alone, stuck, and fearful in those oppressive environments. I hope they find their way out of the dungeon, because they already have the key, they just have to turn it.

The Fallout Continues...

Tonight I did a radio show on breast cancer awareness month and pinkification of October. It was fun, especially when I was scheduled for a 30 minute show and the host suddenly, a few seconds before we started, saw something that erroneously told her we were on for 60 minutes. I was fine with that, I had plenty of material and I could talk forever about these topics. We slowed everything down to stretch it out, and then suddenly, 5 minutes before the 30 minute mark, someone tapped on the door to tell her the show was only 30 minutes, so she let me get my last words in and I scrambled to say all of the important points in the last 3 minutes or so. Crazy, but fun anyway.

After the show we talked for a little while casually about health care and I mentioned my challenges in getting my business off the ground. One of the biggest assumptions I made at the beginning was about how I'd market my services. I thought doctors would be interested in what I was doing and welcome it. Well, getting to talk to a doctor face to face has only happened enough times to count on one hand, and most of those were by accident when I ran into them in town somewhere by chance, like in the grocery store.

The way I see it is, I have this great service that would be so good for their patients, but I can't even get 5 minutes of their time to talk with them about it. They just don't prioritize that, it's a different way of operating than they are used to, and now with fierce competition in town, everyone is protecting their own turf and profits. They see anything outside of what they do as competition.

The host of the radio show, who works in health care herself, told me that a doctor she knows thinks physicians are slow as snails to adopt anything new, she said on the order of 17 years (about as long as a new drug patent used to last before the generic could be marketed).

We are still being inundated with Ebola everything, and I have read some highly astute observations from people at the direct care levels of health care, physicians, nurses, infection control specialists, and techs on the state of health care in this country. Many of the things I have discussed in past blogposts with regard to patient safety and how nurses are treated in the workplace and when they raise concerns about safety issues in the workplace have surfaced in the Texas Presbyterian flap.

I also read with interest this article about how things are being handled at the Biocontainment Unit at the University of Nebraska medical center, one of the hospitals where Ebola cases are treated and they have a solid and effective plan in place for their workers to prevent transmission of the disease. If you go to page 2 they talk about breaking shifts into four hour blocks when dealing with the extreme conditions of having to work in hazmat gear, and on page four, they discuss how they pay attention to the needs of the caregivers.

Some of the things they do could be applied in general, such as allowing time for breaks, to eat and drink and use the bathroom, having behavioral specialists to help people deal with the stresses of working. If you're not in health care, you might think, what? Of course you need to take breaks and eat, drink, and go to the bathroom. If you are a nurse, you're thinking, what a novel common sense approach, and you're already googling on U of N Medical Center to see if they have any open positions on their employment site. You're thinking, hell yes I'll work with those patients in a space suit if it means I get to pee and eat every four hours!

Just think what we could accomplish if safety was our top priority. We'd have to slow down, and maybe take care of the needs of the employees who are taking care of patients. And then maybe we could have zero hospital acquired infections, and instead of thousands of medical errors they would be as rare as Ebola in the U.S.

Why is it that in health care, when we should be staffed by smart people making good decisions because we are relying on them to take good care of our health when we are sick and dependent on them, that it turns out we are at the mercy of irresponsible, detached, myopic decision-making at the highest levels of the organization which trickle down to the front line workers being abused and working under inhumane conditions?

The other thing I noticed was that under the CDC new guidelines, which they released after a bunch of health care workers (namely nurses) made A LOT OF NOISE about the inadequacy of the first few messes they sent out...the new guidelines clearly state that management and leadership (ha- see my blogpost from a few days ago) are responsible for seeing that the guidelines are implemented and followed. Read: Five Pillars of Safety and I quote:

Five Pillars of Safety

CDC reminds all employers and healthcare workers that PPE is only one aspect of infection control and providing safe care to patients with Ebola. Other aspects include five pillars of safety:
•Facility leadership has responsibility to provide resources and support for implementation of effective prevention precautions. Management should maintain a culture of worker safety in which appropriate PPE is available and correctly maintained, and workers are provided with appropriate training.
•Designated on-site Ebola site manager responsible for oversight of implementing precautions for healthcare personnel and patient safety in the healthcare facility.
•Clear, standardized procedures where facilities choose one of two options and have a back-up plan in case supplies are not available.
•Trained healthcare personnel: facilities need to ensure all healthcare providers practice numerous times to make sure they understand how to appropriately use the equipment.
•Oversight of practices are critical to ensuring that implementation protocols are done accurately, and any error in putting on or taking off PPE is identified in real-time, corrected and addressed, in case potential exposure occurred.


A culture of worker safety. Hmm. And what culture is that? It's the one that is greatly exaggerated by most corporate leadership accounts. If something interferes with the bottom line, there will be a workaround. Somehow...

And somehow...University of Nebraska seems to get it, but that safety culture needs to expand throughout the health care system in this country, and profit-centered models of health care are not going to welcome it.

Certainly that culture was nonexistent at Texas Presbyterian, where they couldn't figure out that their PPE was inadequate or spend the money to transport a patient to where someone knew how to take care of him...yet they had plenty of money to hire an expensive PR firm to tell them how to handle their image after their disastrous mistakes that repelled patients to the point where their hospital is nearly empty now.

The culture at Texas Presbyterian, the same one that has administrators telling nurses not to go to the media or they'll be fired, the same one that resulted in one nurse blowing the whistle and we know she'll never be able to go back to working for that hospital again because of the retaliation she will face. Lawyer or not, the hostility directed at her after speaking the truth will make it impossible for her to carry out her duties, as they'll be watching her every step and finding ways to harass her until they get rid of her.

This is the reality of health care, folks. And it needs to change. If you're not in health care, this is what goes on behind the scenes when you or your family member is being "taken care of". This is what the nurses endure. This is what physicians are forced to work with, administrators who are unresponsive to their needs too.

This is what I've been screaming about so passionately for a long time, and finally we have a crisis that has brought these issues directly to the surface. And a lot of organizations are going to deny that they do business this way, and defend their own practices with lawyers, PR tactics, and doing whatever they feel they can get away with. "We're not like Texas Presbyterian" will be the cry of protest. But right now, every one of these organizations is scrambling to give the impression that they are prepared and trying to minimize their expenses to protect their profit. Some are more prepared than others, but the culture is what needs to change across the board.

This is health care in the U.S. naked.

Do you care yet?

Leadership is just another word for...

Yes. As in yes men.

One of the things you see in organizations is the habit of naming certain people as part of the LEADERSHIP. They LOVE the L word. They love to hear themselves say it.

They emphasize to everyone that THEY are the designated leadership team. That gives them privilege, they get to sit in on meetings and are privy to additional layers of company secrets that the underlings are not. They also get to escape accountability as a perk. They get to blame other people for failure, but leaders stay clean. 

The moment anyone DOES try to hold them accountable though, they hide behind the other big L: Lawyers.

Leadership has become simply another word for yes man.

What we needed in the face of the Ebola problem, as in so many other events, was a leader. Solid decisive action. We did not get that. We got buddies of the President appointed out of political favor instead.

You won't hear me criticize Obama very often. I don't usually mind when people do, though, because I don't mind other people having opinions that differ from my own, and I don't need to be right.

As long as it's not some troll spewing mindless racist hate or parroting abject stupidity, I just let it be. I have my own political views and I'm not afraid to say I tend to lean very much toward the left most of the time. But I also think it's important to remember that we are talking about public health and safety, and Ebola doesn't care if you're a Republican, Democrat, or Purple. Nurses don't refuse to take a patient based on their political affiliation. We're all human beings and we're all affected by this.

That said, I am very disappointed in Obama for this appointment of a so-called "Ebola Czar." This guy has no health care or public health experience whatsoever. He's an attorney and works with big business, and therefore has no clue about the things that frontline health care workers do or deem important.

We have a problem in this country and it's lack of true leadership. True leadership is not the fake kind taught at Harvard Business School. Look at the people in Congress, for example. They won't even act on minor issues because it's midterm election season. Where are their priorities? They certainly are not with the people of this country. They prioritize their own reelection so they can continue to prey on the well-funded palms that feed them, the ones who got their money by preying on the public.

We need to string them up by the part of their anatomy that is most sensitive to pain and say, you need to act. Quit protecting your own turf and do what we're paying you to do. Remember we are still paying them, in terms of benefits like health care and retirement, and it's out of our taxes, which we pay disproportionately more of than their rich buddies. The perks from lobbyists and guarantees of golden parachutes are much more lucrative, and as long as they keep it so, the people are screwed.

Career politicians are not leaders, just like the so-called leaders of corporations. Self-interest. Greed. Power. Those are the things that motivate these people. As long as they are safe, comfortable, and profitable, they won't do a damn thing to change.

This is what happens in corporations. I can remember working in the hospital and there would be these "leadership" meetings that always consisted of roughly half the unit staff, while the other half stayed and worked. All of the so-called leaders were in their positions due to length of time they'd been there or the fact that they were the biggest kissasses, and/or the most toxic people on the unit.

This is an aside, but I couldn't help thinking, when I saw what happened to Nina Pham, the first U.S. nurse diagnosed with Ebola in Texas, that she must have somehow drawn the short straw on assignments that day. Or maybe she volunteered for the challenge. I can remember the nasty charge nurse I had to deal with in ICU who would always give me the most distasteful assignments that she'd never give to her buddies. When I was a new nurse, I used to ask for more challenging assignments, but what usually happened was I got the patients no one else wanted. Had Ebola come to the unit I worked in, I probably would have been the one given the Ebola patient without adequate protection.

Who knows what they discussed in those meetings, I was never invited. I was one of those dangerous people who questioned things and might actually think for myself. I stayed and took care of patients while they "led" in the conference room. They never communicated to the rest of us what was discussed in those meetings. Occasionally we'd ask them to, and they'd pretend they would do it, but they never actually got around to it.

There were always a lot of leaders relative to the non-leaders. It was more of a secret club than anything. You'd have to somehow demonstrate your loyalty to the system before you could be granted admission. And just how you did that, was never made clear. There was never a book of rules, or a playbook that was shared with everyone. That's how you keep the underlings in line. People who want to do things and take action are not the ones who are valued in these organizations. It is the sheep who stay, are promoted, and kept.

Do a shitty job, keep your clique in place, and get rid of anyone who thinks critically or has ideas? Get promoted to an executive position, created just for you.

Take action on a patient safety issue? You're fired. We don't want the world to know that we really don't value patient safety, that it interferes with the bottom line.

Business schools and law schools don't produce leaders. Actually most schools don't. They provide didactic knowledge, but it's not applied to any real world situation very well, if at all. Experience and demonstrated decisive action do. That's one reason why we've always valued military service when people ran for president.

I am not sure that the military is any better of an organization but it certainly does provide opportunities to demonstrate leadership. With all the changes in the military I am not sure that it provides what it used to. But I do know that in my health care experience, I have seen the establishment frat boy culture completely diss a newcomer with military experience and common sense, when they could have learned and gained from his ideas.

The frat club of business school-educated "leaders" knows how to work the system to eliminate any common sense or true efficiency from the system. They pretend to implement systemic changes which really only serve their bottom line, and usually result in inefficiencies for the people who do the real front line work.

Some have called for an office of a National Nurse, another ball that has been dropped in our pathetic Congress. If there had been a national nurse (not to mention a Surgeon General and adequate funding) in place prior to the Ebola incident, perhaps we could have avoided this mess.

What's it gonna take? Well first, we have a midterm election coming up. You can start by voting for people who have demonstrated competent leadership. A newcomer, preferably, not an incumbent. We can make sure that anyone running for President who gets as far as the primary is thoroughly examined by the public to look for true leadership ability and experience, not a career politician.

And we need to insist, like National Nurses United has demonstrated so well, on our voices being heard, our recommendations being implemented and taken seriously, and not backing down to the fear tactics currently used in the corporate playbook that result in voices acting in the public's best interest being threatened and squelched.

The one nurse from Texas who blew the whistle and went to the media? She is a hero. She is risking her livelihood but she is protecting the public, and that's more important. She will find work, perhaps not in a corporate health care system, but someplace where she can do meaningful work.

We have got to stop allowing these business school educated, incompetent people to run our health system. We need people who know the health care landscape, who have experience, boots on the ground, and know how to take action in a crisis.

You wouldn't allow the CEO to run a code, would you? Why should they run the hospital at all?

Health care and public health are not a business. Stop running it like one.

Curse The Nurse: Not Gonna Fly

The chickens came home to roost. The old knee-jerk response out of the administrative playbook, blame the nurse, it's the nurse's fault, is not going to work anymore. Playing the game I call Curse the Nurse.

National Nurses United had the cojones to address the situation head on, instead of the pathetic response from the American Nurses Association. No wonder no one joins the ANA. They don't do a damn thing for nurses, they are part of the problem.

Just a few brief thoughts here as I am busy today with other things, and I want to attend the teleconference being hosted by National Nurses United about the Ebola issue.

Playing Curse the Nurse: It's a problem that happens from the lowest levels of management to the highest levels of national agencies. If you as a nurse let your manager know that there is not enough working equipment on the unit, they are likely to say, "Well, what are YOU going to do about it?" (implied: in between caring for 4 or more patients)

From a foot-dragging response to concerns about patient safety on the unit that could easily be fixed with an inexpensive solution, to passive-aggressive spying tactics and manipulation of coworkers to skew employee reviews, to playing dumb "I don't recall having that conversation", management plays this game flawlessly. They get away with it.

And as the CDC has shown us, it's a convenient tactic at any level of the health care industry. Blame the nurse for all the problems. Blame the people with little power and few resources for the missteps of those who hold all the power and all the resources.

Blame the nurse for breaching a virtually nonexistent, and at best, totally inadequate protocol. Tell other nurses, when your mistake is discovered, that they'll be fired if they say a word to the media.

Profit-mongering, covering your ass, and playing these big business games are unacceptable in healthcare. When it comes to public safety and patient safety, nurses don't operate like that. We are there for the patients first. No big executive bully is going to tell us we can't go to the media or we'll be fired. Being fired is better. Who wants to work for scumbags like that?

Provide the right equipment and training, quit screwing around and counting your beans, and take people's lives seriously.

The truth comes out. Oops.

Here is my friend Andrew Lopez on the issue.

There are additional public health issues coming to light as we discover that a second health care worker in Dallas has Ebola, and may have flown on a commercial flight with 130 other passengers. There are the issues of flying & travel, e.g. surfaces in airplanes, poor hygienic practices of staff who easily cross-contaminate the public: flight attendants, airline companies, restaurant workers, hotel housekeeping staff.

But we aren't even there yet. What I am hoping is the silver lining, in this Ebola outbreak, whether it is contained at a handful of cases or becomes something larger, is that the public will be made aware of just how dangerous a big-business profit model is to their health and safety.

I'll have more to say later.

What Color is Your Crisis?

Pretty freaking amazing. Now the news media are going batshit over the Ebola story. What I find interesting is that none of the administrators of the hospital in Texas have come forward to talk about their own culpability in the "systems errors" that have been blamed for the discharge and re-admission of the patient with Ebola.

You'd think it was Ebola Awareness Month instead of Breast Cancer Exploitation Month. Instead of the Pink Scourge, now it's Purple and Yellow.

Yup, the so-called health care world is going to hell in a handbasket, and none of the people at the top can take any responsibility. No one seems to hold them accountable. They do make the big bucks.

Point the fingers: at the nurses, the doctors, the computers, the "systems". But who makes the systems? Someone has to. They don't create themselves. Someone has to make the decisions to follow certain protocols and set things up the way they are. Someone is benefitting from things being the way they are.

Well eventually the Ebola scare will pass, just like AIDS and HIV freaked everyone out at the beginning until they understood how to control it and contain it.

I watched this short little interview on MSNBC with the head of the Texas Nurses Association and I had to comment. It was just too much for me to keep my mouth shut. Watch the whole thing but especially the end part when they interview the Executive Director of the TNA.

I wrote this in the Joy Reid Facebook page. I haven't heard a response, but then I don't expect to. The media wants sensational stories, not reality.

"In your interview with the head of the Texas Nursing Association I could not help but notice that this woman hemmed and hawed but refused to address the real issues in health care that threaten public health. The rushed environment, chronic understaffing, and the second class citizen status of nurses all contribute to these “systems” errors, to which she kept referring.

Nurse informaticists’ concerns are not listened to when they are working on these EHRs but even worse, most nurse informaticists are not currently working at the bedside and are unable to see what is happening NOW.

Furthermore, nurses are silenced and their jobs are threatened for raising concerns about safety issues, they are treated like second class citizens in health care, they are not represented on boards, those who do the front line work of taking care of patients are not the ones whose ideas are tapped for making common sense developments of EHRs, the workflow is separate for nurses because doctors don’t want to be bothered reading nursing notes even though they contain lifesaving information.

What about the failure of administrators and executives to be held accountable for "systems" failures? Isn’t that why we pay them the big bucks? Shouldn’t they have a duty to protect the public from faulty “systems”?

The head of the TNA sounded like she had no clue about what really goes on in the hospital setting. I would like to see the press interview a nurse who could really tell it like it is. The ANA nationally has a tiny fraction of our country’s 3 million nurses as members because they simply don’t represent real working nurses’ interests."


Yup. We've got ourselves an epidemic on our hands, but it ain't pink, purple or yellow. It's black and navy suits. Hiding out behind their "systems".

They need a good disinfectant. Like, sunshine.

The real crisis is the failure to hold any of these suits accountable for their actions that harm public health.

Oligarchy Meets Theocracy...

And they didn't use birth control, so now we're living with their offspring.

Wow, Supreme Court men, thanks a lot from the women of the country. We appreciate that you hold the gender majority in the highest judicial branch of government, when the majority of the population are women. We appreciate that you don't consider the precedent you've created when your job is to carefully scrutinize your decisions in light of the precedents they set.

This is a wart that's grown out from the Citizens United decision, and it's destined to get worse, now that you've given fodder to every corporate religious zealot out there who wants to impose their beliefs on people's personal lives. Corporations clearly now have religious beliefs, because they are people. Freedom of religion doesn't mean freedom from religion. I really wonder these days why we have a first amendment at all. The media have been weakened as a force to protect citizens, and corporations use their balls to duct tape over anyone's mouth who points out their corruption.

The Voting Rights Act, Title IX, and EEO laws are being regularly eroded and abused by corporate bullies and their lobbyists. The Good Ole Boy network is alive and well, and so is white supremacy for that matter. We are still struggling with recognizing non-heterosexual people as worthy of full status as equal human beings. We go back and forth in a tug of war and never seem to make forward progress.

We need to get rid of Citizens United before it completely erodes anything left of our rights as citizens, and in many cases, our human rights. I'm not sure if we've completely lost any hope of ever taking the government back from the 1%. There is a group that's organized to raise money to get rid of Super PACs. It's a grassroots effort and in this country grassroots efforts don't get nearly as much traction as big corporate-backed muscle.

I am trying to live off the corporate employment grid as much as I can, but it's difficult, and to say that I am is hypocritical since my significant other works for a big corporation.

Not really sure how much more I will say about it. Because I could go on forever. I'm not really that surprised. Just disgusted.

Overflowing...

I have so much on my mind, it's hard to hold my tongue, it's overflowing!

The past few days have been busy and full. I'm trying to prepare for an hour-long radio show next week, and I got a new client last week, and then got a call from a former patient yesterday who wants me to come work with her. I met with an advertising rep from a paper in a nearby town, and I'm staying on top of things, but the pace has increased.

Working with clients has been rewarding and satisfying beyond description. I loved working with patients at the hospital but you were so limited in what you could do or say. There wasn't enough time to give them. Now I can spend the time, and give them the attention I always wanted to.

When I got the call from my former patient, it was this feeling of gratitude that came over me, I felt like melting into the ground. I happened to really like working with this person and I felt like I'd just been handed a gift. To be able to help someone in ways that they never can be helped in traditional health care.

It was a strange coincidence, maybe, that the same day I got the call from the former patient, I also ran into one of my former co-workers, and was contacted by another former co-worker on Facebook. I was out running and saw one of the nurses I used to work closely with. We spent a lot of time talking and catching up, and whenever I hear from people I used to work with, they say things haven't gotten better. They look tired, spent, and are looking for ways out.

It's so sad. I think it's sad that in our rush to implement the ACA we've allowed the new health care model to be a wholly profit-centered big corporate one, where the people calling the shots have no idea about what it's like to work directly with patients as a health care provider. Fits right under the armpit of our oligarchy. I have a lot to say about that, as you already know if you've followed this blog for any length of time.

And I am writing about it...and will be putting quite a bit of time into that project before long.

Which reminds me, this cartoon from this tweet by @MalwareTechBlog cracked me up this morning!

Ran with Wheaties Boy at the cemetery this morning. I ran as hard as I could but only got into the 7:20s for my miles. My legs are still tired, but at least I was consistent and I did them. I will have improvement in the coming weeks. I feel better this week but my legs are still sluggish. The half-marathon on Sunday should be interesting. I am so glad I didn't sign up for the full marathon. I will end up with between 75 and 80 miles this week.

Last night I made a pizza at home on my travertine tile in the oven. It was for sure the best pizza I have ever made, thanks to the tile. It works the same as a pizza stone. You have to use an unglazed tile. I need to get motivated to post the recipe on Bitchen Swill. I got the ingredient ideas from Whole Foods but I did it differently than they do.

A few weeks ago I was starving and walked into Whole Foods (generally a verybad idea) but they had these different pizzas, and I tried a couple, and this one was amazing. It was a barbecue sauce base with barbecue beef brisket and pineapple, some hot peppers, and I can't remember what else. But I decided I needed to make it for Dennis. I used fresh mozzarella cheese, cilantro, red onion, and tabasco in addition to all those things and of course my own pizza dough recipe, which worked out much better on the tile.

For our anniversary I asked for a pizza stone- or something like it, and a tile is a lot less expensive. Even though I do shop at Whole Foods on occasion, I don't like to pay more for something than I can get at a much more reasonable price. When I found out you can use an unglazed tile as a pizza stone that's what I asked for, on one of Dennis's trips to Home Depot. Where else can you get your wife an anniversary present for a couple of bucks?

The one thing I've had to push back is writing. I really want to work on my writing project and all these other things are priorities right now, but I have one more presentation in mid-July to prepare for, and it won't take too long, but as soon as the radio show is done I will have more time to focus on the writing. I have so much I want to say, things that want to spill out of my brain constantly and I've been making notes and the notes are piling up and taking over! So much to say...

Can't Fix Stupid...

A gaggle of goslings...

On run number two, I met Emma at River Bluffs Open Space and we did a quick 6 miles at a good pace on the bike path. We had a great talk. I always appreciate being able to share our perspectives on all things. On the way out we saw these geese with their babies.

I stopped to take a picture but I couldn't get too close, sorry about the unclear photo, I didn't want to upset the mother, who started to hiss at me. Having been attacked by geese before while running the Mad Dog 50K in Arizona, I wasn't about to risk it...

On run number three I took Iris through the neighborhood for a short one after I got home from the run with Emma. Thirteen miles today, and now it's time to back off.

Time heals, and time reveals. I am learning that quickly, the universe is showing me that I have made the right decision on a daily basis, sometimes more often than daily. Sometimes the revelations are shocking, amusing, appalling, or just an affirmation that you can't fix stupid. Just a simple run last weekend on the bike path and running into someone, and listening to what they had to say, opened my eyes even further to this.

Where things seemed very fuzzy and cloudy initially when I left traditional health care last fall, it seems like on a regular basis now, both through face-to-face conversations, people who have contacted me both in response to my inquiries or unprompted by me, and occasionally in written form such as the link that follows, I am getting insight and validation into the types of decisions and uncritical thinking that guide modern health care. It's really scary.

Nurses' Week is coming right up. I am the queen of snark when it comes to Nurses' Week. Can't wait!